THE ROLE OF NEUROPLASTICITY IN RECOVERY FROM TRAUMATIC BRAIN INJURY: A SYSTEMATIC REVIEW

Abstract

Background: Traumatic brain injury (TBI) is a leading cause of long-term cognitive, emotional, and motor impairments worldwide. Emerging evidence highlights the dual role of neuroplasticity as both a mechanism of functional recovery and a potential contributor to maladaptive changes. This systematic review synthesizes findings on the relationship between neuroinflammation, neuroplasticity, biomarkers, and rehabilitation strategies to better understand how neuroplasticity can be harnessed to optimize recovery.

Methods: Following PRISMA 2020 guidelines, a systematic search was conducted across PubMed, Scopus, Web of Science, and Embase for peer-reviewed articles published between 2010 and 2025. Studies included randomized controlled trials, cohort studies, case-control studies, and experimental preclinical work addressing neuroplasticity, inflammatory processes, and therapeutic interventions in TBI. A total of 26 eligible studies were analyzed through narrative synthesis, categorized into neuroinflammatory pathways, biomarkers, structural and functional imaging, and rehabilitative interventions.

Results: Evidence demonstrated that neuroinflammation and microglial activation disrupt synaptic plasticity and cognitive function (Aungst et al., 2014; Witcher et al., 2021). Biomarkers such as serum amyloid A1 and neurotrophins were identified as predictors of injury severity and recovery potential (Carabias et al., 2020; Lin et al., 2021). Interventions including cognitive rehabilitation (Cooper et al., 2017; Mahncke et al., 2021), music therapy (Siponkoski et al., 2020; Thorpe & Byrne, 2025), and novel technologies such as virtual reality (Du et al., 2025) and stem-cell-based therapies (Xu et al., 2020; Zhang et al., 2023) were shown to enhance adaptive neuroplasticity. However, maladaptive remodeling, such as abnormal cortical thickening (Dall’Acqua et al., 2017), underscores the need for careful therapeutic targeting.

Conclusions: Neuroplasticity represents a dynamic mechanism underlying both recovery and pathology following TBI. Integrative approaches targeting inflammation, optimizing timing of interventions, and leveraging multimodal rehabilitation hold promise for maximizing adaptive plasticity while minimizing maladaptive outcomes.